I had a D&C due to retained placenta two weeks

Patient

Q: I had a D&C due to retained placenta two weeks after I have birth to my 3rd child last May. My husband and I want one more child, but since then I've been having problems. The Gynecologist they sent me to for my D&C blew me off when I tried to talk about my concerns. I'm only 32, so I think I'm too young for menopause.

Since the D&C, sex hurts. On top of that my breasts, which have always been a particular hot spot for me, are almost numb. When my husband tries to stimulate my nipples, he could be rubbing my arm for all the difference it makes. Also, my periods have been shorter and irregular even though they've always been so similar you could set a clock by them. I also will have pelvic pain (sometimes random) after sex that will last for a couple days. My vaginal opening will sometimes hurt for no apparent reason.

I'm really concerned that they screwed something up and I can't get anyone to listen to me about it. We want one more child. 32 is too young to be forced out of having children.

Symptoms:  Pelvic pain, pain with intercourse, breast numbness
Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
The fact that you have undergone a D & C after your last delivery and just 2 weeks after delivery due to retained products of conception, there are high chances that there may have been adhesion formation or something what we call as ASHERMAN Syndrome which can classically occur post endometrial curettage in early post partum period when the uterus is still involuting or undergoing involution to return back to its pre-pregnancy state.

The increasing decrease in flow and delay in periods can be explained with this possibility and this can be an issue to prevent future conception as well. The decrease in breast stimulation and breast numbness
can be explained with a possible decreased libido due to stress per se and that can be modified and taken care off slowly by adopting anti-stress measures.

Painful intercourse throws a likely possibility of again a uterine injury or endometriosis which can cause pain. The asherman syndrome or the intrauterine adhesions can prevent uterus from contracting naturally during orgasm o intercourse and hence can be painful. There is a strong suspicion pertaining to the diagnosis. I shall suggest you to opt for an ultrasound pelvis preferably trans vaginal route first and then a MRI if further suspicion is raised. This can help clear the diagnosis first. Then nextly if confirmed, it would be required to be hysteroscopically operated upon to remove the intra-uterine adhesion.

Please review with your physician to discuss further and a definite ultrasound pelvis.
I hope i have answered your query in detail,
Wishing you good health,
Regards

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